In a lot of ways, Ben Pratt is a typical rambunctious 3-year-old.
He seems constantly on the go, and has a stubborn streak. He loves the Disney Pixar movie Cars. He has a mischievous laugh when he's being a little naughty, and loves to draw and color, sometimes on the wall.
His parents, Shayla and Greg Pratt, decided not to put his Lightning McQueen and train toys under the tree until Christmas morning this year to keep him from opening them early, as he did with several presents last year.
But Ben received an early, extraordinary gift this holiday season: a kidney from the nurse who cared for him after he was born with kidneys that didn't work.
Beth Warren was Ben's primary nurse in the neonatal intensive-care unit at Kentucky Children's Hospital in Lexington, where he stayed for more than four months after he was born Aug. 22, 2009.
Warren fell in love with the blue-eyed baby and grew close to his family, who live in Perry County. Shayla Pratt, who also is a nurse, was at the hospital every day during the long months Ben was there.
The decision to give Ben a kidney wasn't hard, Warren said.
"To me, he's been just part of my family," she said. "I knew this was God's plan for us."
On November 20, surgeons at Cincinnati Children's Hospital removed one of Warren's kidneys, then made an incision stretching from just below Ben's rib cage down to and across his pelvis, and implanted the organ.
Now, with a kidney that works, Ben can eat many foods he couldn't before, from bananas to French fries. He's gained four pounds since leaving the hospital Nov. 30, weighing in at 33 pounds.
Ben was always a happy kid, but it's obvious he has more energy these days, his mother said.
"He acts like he feels so much better. It's amazing," Pratt said.
There was no reason to suspect problems before Ben was born.
His older sister Morgan, who is 5, is healthy, and his mother had no problems when she was pregnant with Ben.
But he was having trouble breathing after he was born. He had a collapsed lung, and doctors quickly figured out his kidneys weren't working.
The organs hadn't developed correctly because of a blockage in his bladder, Pratt said.
It's a rare condition. Most newborns with a similar condition wouldn't have survived, because their lungs wouldn't have developed, Pratt said.
"He's a miracle," she said.
Ben started on dialysis when he was three days old. Doctors implanted a catheter in his abdomen, and he had to be hooked to a machine for hours each day to clear toxins from his body.
Warren had been a neonatal nurse for years at the time, so she was no stranger to sick little ones.
She keeps in touch with some other families, but Ben was the first newborn she'd cared for who had to be on dialysis, and she got more attached to him than any of her other patients.
Ben "seemed to hold a special place in her heart," Pratt said. "He bonded with her like he would bond with me."
Warren was off work the day Ben was finally discharged, but came in to see him off.
She gave him a copy of the Dr. Seuss book, "Oh, the Places You'll Go!"
Warren, 40, who is divorced and could not have children, remained close to Ben and his family after he left the hospital, traveling to their neat home in a hollow at Slemp for birthday parties and other occasions.
"I love that little boy just like I would my own," Warren said.
Doctors had told Ben's parents very soon after he was born that he would someday need a kidney transplant, but he needed to weigh 20 pounds first, said Shayla Pratt.
It took him a while to build up to that weight because he had food allergies, but in 2011, doctors started testing family members to find the best match to donate a kidney for him.
His mother was nearly a perfect match, but doctors found she had multiple arteries to both kidneys.
The donor was required to have only one artery to the kidney to be removed, Pratt said.
"I was disappointed," Pratt said.
One after another, tests ruled out other potential donors.
Ben's father, an employee of Whayne Supply who services and repairs heavy equipment, also had multiple renal arteries. So did one of Ben's aunts who got tested.
Several friends weren't the right blood type. A cousin wasn't a match. One friend of Shayla Pratt's who volunteered to be tested had been in a car wreck; doctors ruled her out because of the injuries she had suffered.
Ben had to be hooked to the dialysis machine 10 to 12 hours each night. As the months stretched on, the procedure wasn't clearing his system as well as doctors wanted, Pratt said.
In addition, Ben had high blood pressure, which is common among people with kidney problems, and it was becoming more worrisome.
Ben's doctors started talking to his parents about putting him on the list to receive a kidney from a deceased donor, Pratt said.
Ben would have gotten priority for a kidney, but there would have been more potential problems with a kidney from a person who had died, and it wouldn't have lasted as long as a kidney from a living donor, Pratt said.
Warren knew her blood type matched Ben's, and had said soon after he was born that she would be willing to get tested as a potential donor.
The Pratts were reluctant to make such a monumental request.
But when Pratt told Warren about the discussion of putting Ben on the list to get a kidney from a donor who had died, she insisted on being tested, Pratt said.
It turned out she was almost as good a match as Ben's mother.
A battery of additional tests over several months showed she had one renal artery, that her kidney function was good, and that she had no other health problems that would prevent her from donating a kidney.
The surgery would require Warren to be off work six to eight weeks. She'd had migraines and terrible nausea after an earlier surgery because of her reaction to anesthesia. She knew she would encounter those issues again.
Still, she didn't hesitate to pursue giving Ben a kidney.
"I wanted to see him have a normal childhood," Warren said. "He's an amazing boy."
Ben was in surgery more than five hours.
When his parents told him the next day they were going to check on Beth, who was also still in the hospital, Ben had a message for her: "I love you, Beth."
Warren has bounced back less quickly than Ben. She has been sore and hasn't regained her normal energy level, but said she would go through it again any day to help Ben.
"His life is changed so much for the better now," said Warren, who credited her family and co-workers for great support.
Ben's maternal grandfather, Clayburn Shepherd, said after Ben got home from the hospital, he felt so much better he didn't have words to describe it. He would jump and shake when someone asked him how he felt.
He will have to be on medicine the rest of his life to keep his body from rejecting the kidney, but he is no longer on medicine for high blood pressure, and hasn't had to do dialysis since the surgery.
Doctors plan to remove the catheter from his abdomen early next year, Pratt said.
Since he was born, Ben hasn't been able to get in a swimming pool or take a bath because of the catheter. He's only had sponge baths, but soon, he'll get to splash in the tub with new toys his mother bought him.
"There'll be water on the ceiling," said Shepherd.
What Warren did for Ben, for his family, was amazing, Shayla Pratt said.
"We'll be eternally grateful for that."